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. 2013 May 24:13:51.
doi: 10.1186/1471-2377-13-51.

Predictors of long-term survival among first-ever ischemic and hemorrhagic stroke in a Brazilian stroke cohort

Alessandra C Goulart, Tiotrefis G Fernandes, Itamar S Santos, Airlane P Alencar, Isabela M Bensenor, Paulo A Lotufo

Predictors of long-term survival among first-ever ischemic and hemorrhagic stroke in a Brazilian stroke cohort

Alessandra C Goulart et al. BMC Neurol. .

Abstract

Background: Few studies have examined both ischemic and hemorrhagic stroke to identify prognostic factors associated to long-term stroke survival. We investigated long-term survival and predictors that could adversely influence ischemic and hemorrhagic first-ever stroke prognosis.

Methods: We prospectively ascertained 665 consecutive first-ever ischemic and hemorrhagic stroke cases from "The Study of Stroke Mortality and Morbidity" (The EMMA Study) in a community hospital in São Paulo, Brazil. We evaluated cardiovascular risk factors and sociodemographic characteristics (age, gender, race and educational level).

Results: We found a lower survival rate among hemorrhagic cases compared to ischemic stroke cases at the end of 4 years of follow-up (52% vs. 44%, p = 0.04). The risk of death was two times higher among people with ischemic stroke without formal education. Also, we found consistently higher risk of death for diabetics with ischemic stroke (HR = 1.45; 95% CI = 1.07-1.97) compared to no diabetics. As expected, age equally influenced on the high risk of poor survival, regardless of stroke subtype.

Conclusions: For ischemic stroke, the lack of formal education and diabetes were significant independent predictors of poor long-term survival.

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Figures

Figure 1
Figure 1
Kaplan-Meier survival curves during 4-year-follow-up according to age strata (A), race-self reported skin color (B), educational level (C), marital status (D), diabetes (E) and stroke subtype (F).
See this image and copyright information in PMC

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